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Aspiration Pneumonia & Respiratory Failure (Diagnostic Testing (Lab…
Aspiration Pneumonia & Respiratory Failure
Medical Management
Medications
Antiobiotics
Steroids
Lines & Tubes
Feeding Tube (surgically implanted)
Supplemental Oxygen
Mechanical Ventilation
Prognosis of aspiration PNA depends on:
surface area of lung affected
severity of PNA
Type of bacteria causing infection
Diagnostic Testing
CXR
Lab values
ABGs
CBC
sputum gram stain
blood cultures
bronchoscope
chest CT scan
Physical Findings
PNA
tachypnea
decreased breath sounds
dullness to percussion over areas of consolidation
rails
egophony and pectroiloquy
pleural rub
AMS
hypoxemia
hypotension
Fever or hypothermia
ALS
tripping
foot drop; "slapping" gait
reduced finger dexterity
muscle cramping, stiffness
wrist drop
slurred speech, hoarseness, hypophonia
aspiration
Bulbar signs
dysphagia
drooling
hypernasality -> strained, strangled voice quality
loss of speech
Pathophysiology
ALS with bulbar onset leads to difficulty swallowing/atrophy of musculature
Food left in pharynx/unable to cough it out
Gastric content/ bacteria enters lung
Inflammatory response: Injured cells release chemical (histamine, bradykinin, and prostaglandins)
Increased cellular permeability and blood vessels dilate
fluid enters interstitial space
alveoli edema formation & exudate formation
Alveoli and bronchioles fill with serous exudate, blood cells, fibrin, and bacteria
1 more item...
due to the atrophy of the inspiratory musculature are predisposed to a decrease in vital capacity of the lungs
Decreased lung expansion
Hypoventilation
Increase in CO2 in the lungs
Hypercapnia Respiratory Failure
